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Prognostic value of ankle brachial index for future incident heart failure in patients without previous heart failure: data from the impressive predictive value of ankle brachial index for clinical long term outcome in patients with cardiovascular disease examined by ABI study

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Abstract

The ankle brachial index (ABI) is regarded as a predictor of future cardiovascular events. However, the relationship between ABI and incident heart failure (HF) in patients without previous HF is poorly understood. This study aimed to assess the prognostic value of ABI for incident HF in patients without previous HF. The IMPACT–ABI study was a retrospective, single-center, cohort study that enrolled and measured ABI in 3131 patients hospitalized for cardiovascular disease between January 2005 and December 2012. From this cohort, 307 patients were excluded because of previous HF and high (>1.4) ABI. The remaining 2824 patients were stratified into three groups: low ABI (≤0.9), borderline ABI (0.91–0.99), and normal ABI (1.0–1.4). The primary endpoint was hospitalization for HF. Over a mean 4.8-year follow-up, 105 cases of HF occurred. The cumulative incidence of HF was significantly higher in patients with low and borderline ABIs than in those with normal ABI (19.3 vs. 21.0 vs. 10.4 %, log rank P <0.001). In multivariate Cox proportional hazard analysis, low ABI and borderline ABI were independent predictors of incident HF [hazard ratio (HR) 3.00; 95 % confidence interval (CI) 1.70–5.28; P < 0.001 and HR 2.68; 95 % CI 1.35–5.34; P = 0.005, respectively]. In conclusion, low and borderline ABI were strong predictors for future incident HF in patients without previous HF.

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Acknowledgments

The authors wish to extend their thanks to Minako Aono for her secretarial and technical assistance.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-0802, Japan

    Hitoshi Nishimura, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Naoyuki Abe, Naoto Hashizume, Tomoaki Mochidome, Mikiko Harada, Kunihiko Shimizu, Wataru Shoin, Koji Yoshie, Yasutaka Oguchi, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama & Uichi Ikeda

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  1. Hitoshi Nishimura
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Correspondence to Hitoshi Nishimura.

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Nishimura, H., Miura, T., Minamisawa, M. et al. Prognostic value of ankle brachial index for future incident heart failure in patients without previous heart failure: data from the impressive predictive value of ankle brachial index for clinical long term outcome in patients with cardiovascular disease examined by ABI study. Heart Vessels 32, 295–302 (2017). https://doi.org/10.1007/s00380-016-0873-3

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